How much rates vary
Facilitymedian $550 · 10th to 90th $151 to $1,122Professionalmedian $479 · 10th to 90th $89 to $708
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $524.81 Median $4,897.79 Typical High $21,877.62 | Facility | None | $524.81 | $4,897.79 | $21,877.62 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $562.34 | Professional | None | $467.74 | $524.81 | $562.34 |
BCBS South Carolina Setting Facility Modifier None Typical Low $302.00 Median $575.44 Typical High $794.33 | Facility | None | $302.00 | $575.44 | $794.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $549.54 | Professional | None | $426.58 | $478.63 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $371.54 Typical High $707.95 | Facility | None | $151.36 | $371.54 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $831.76 | Professional | None | $478.63 | $524.81 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $95.50 Median $501.19 Typical High $758.58 | Facility | None | $95.50 | $501.19 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $691.83 | Professional | None | $512.86 | $562.34 | $691.83 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $416.87 Typical High $724.44 | Professional | None | $38.90 | $416.87 | $724.44 |
United Setting Facility Modifier None Typical Low $83.18 Median $446.68 Typical High $2,238.72 | Facility | None | $83.18 | $446.68 | $2,238.72 |
United Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $758.58 | Professional | None | $371.54 | $478.63 | $758.58 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $95.50 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $389.05 Typical High $416.87 | Professional | 54 · Surgery only | $354.81 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $363.08 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $331.13 | $363.08 | $389.05 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,023.29 Typical High $1,288.25 | Professional | 50 · Both sides | $776.25 | $1,023.29 | $1,288.25 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $257.04 Median $346.74 Typical High $436.52 | Professional | 51 · Multiple procedures | $257.04 | $346.74 | $436.52 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $138.04 Typical High $173.78 | Professional | 80 · Assistant surgeon | $102.33 | $138.04 | $173.78 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $72.44 Median $95.50 Typical High $120.23 | Professional | 81 · Minimal assistant surgeon | $72.44 | $95.50 | $120.23 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $72.44 Median $95.50 Typical High $120.23 | Professional | 82 · Assistant surgeon, no resident | $72.44 | $95.50 | $120.23 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $95.50 Typical High $120.23 | Professional | AS · PA/NP assist | $72.44 | $95.50 | $120.23 |
Where South Carolina sits
The same service costs 4.9 times more in Connecticut than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CT $3,107FL $640
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.